A healthy heart is an organized instrument, using well-timed electrical impulses to send blood circulating through the arteries — "supply wagon" delivering oxygen to the farthest reaches of the body. These electrical impulses occur in a specific order and within a specific time frame — what doctors call normal sinus rhythm. But when something interrupts these impulses, the heart misfires and struggles to contract smoothly. Any interruption in the smooth, steady flow of oxygen-rich blood can make you seriously, even dangerously, ill.
We call it Atrial Fibrillation, or A-fib.
People with A-fib may feel tired, weak, dizzy, and/or short of breath, especially after exercising or lifting heavy objects. Some patients feel their heart race or skip a beat, while others have no symptoms at all. A doctor can use a variety of tests to confirm whether you have A-fib, such as an EKG or a stress test.
Complications of A-fib include a greatly elevated risk of stroke. Therefore our two treatment objectives are to restore normal rhythm and reduce stroke risk.
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Drugs that either help prevent the blood from clotting or help to regulate heart rhythm are a traditional way to treat A-fib. But these drugs have complications and side effects that are expensive and time-consuming to cope with.
Another non-surgical therapy called electrical cardioversion uses targeted electrical shock to stop the heartbeat temporarily. When the heart resumes beating it may return to a normal rhythm, much like pressing the "reset" button.
If these treatments aren't effective, we explore a number of surgical options to replace or complement drug therapy. Kentuckians are fortunate to have access to these procedures, which in some cases aren't available elsewhere in the region.
With a procedure called Mini-MAZE, doctors construct a maze of scar tissue in the heart to reorganize contractions into a normal rhythm.
Other procedures aim to close a small pouch of the heart where clots that cause stroke tend to form.
The Atri-Clip procedure uses small incisions through the chest to deploy a fabric band, pulling the pouch closed much like a rubber band is used to make a ponytail in a girl's hair.
The LARIAT procedure uses two catheters (tubes), each fitted with a tiny magnet. Through small incisions, the doctor guides one magnet inside the pouch, and one outside. Once they click together (much like two magnets between a layer of cloth), a tiny "lasso" is looped around the opening of the pouch and pulled closed like the drawstring on a sack.
Also on the frontier of treatment, but available in Lexington, the AMPLATZER Cardiac Plug operates like a sink stopper to block the pouch opening.
In most cases, these are highly effective and minimally invasive treatments that allow A-fib sufferers to return quickly to an active, healthy lifestyle.